Active NPI
Madison Wing, PHARMD
- Pharmacist
- Polson, MT
National Provider Identifier
1639897622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PHA-PHA-LIC-88655
- Practice address
- 40774 Mt Highway 35
Polson, MT 59860-7745 - Phone
- (406) 883-3674
- NPI assigned
- Aug 16, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHA-PHA-LIC-88655 | MT | Primary |
Addresses
Primary practice location
40774 Mt Highway 35
Polson, MT 59860-7745
Mailing address
40774 Mt Highway 35
Polson, MT 59860-7745
Phone (406) 883-3674
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA-PHA-LIC-88655 | MT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660608000000",
"number": "1639897622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40774 MT HIGHWAY 35",
"city": "POLSON",
"state": "MT",
"postal_code": "598607745",
"telephone_number": "406-883-3674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40774 MT HIGHWAY 35",
"city": "POLSON",
"state": "MT",
"postal_code": "598607745",
"telephone_number": "406-883-3674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WING",
"first_name": "MADISON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-16",
"last_updated": "2022-08-16",
"certification_date": "2022-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MT",
"license": "PHA-PHA-LIC-88655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Polson, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.